Frequently Asked Questions

AIDS/HIV Prevention

Some STDs are easily treated and some STDs stay with you for life. Other STDs are more of a nuisance than a health risk. Pubic lice, or 'crabs,' for example, itch a lot but don`t do any permanent damage. If you get an infection and you want to know how serious it could be, talk with your health care provider. There are four serious health consequences of some STDs:

Blockage of the fallopian tubes which can lead to infertility and ectopic pregnancy

Pregnancy loss and increased newborn deaths caused by transmission of the infection to the infant during pregnancy and childbirth

Genital cancers for males and females

Enhanced transmission of HIV/AIDS

Social and Psychological Consequences: The psychological impact of having a sexually transmitted disease can be severe. Some persons become depressed or anxious. They fear recurrent outbreaks, transmission to sex partners, and difficulties in developing new relationships. Fortunately, proper treatment and knowledge about the true risks can greatly lessen all these effects.

Condoms are not 100% effective at preventing HIV transmission. When used correctly and consistently, condoms are highly effective and reliable in reducing the risk of transmitting HIV and most sexually transmitted diseases (STDs). Condoms should be used EVERY TIME during sex when transmission of HIV (or other STDs) is possible. When condoms fail to work properly, it is most often because of improper and/or inconsistent use.

Condoms may not work as well against STDs spread through skin-to-skin touching, like herpes and genital warts, because condoms may not cover the infected areas.

Following these basic rules will reduce the already small chance of condom failure: - Experiment with different condoms and practice putting them on before intercourse. - Practice talking with your partner about your desire and intention to use condoms. - Use latex (rubber) or polyurethane (plastic) condoms. Avoid "natural skin" condoms, which have tiny holes, which may allow HIV and other STDs to be transmitted. - When using a male condom choose one that fits. Male condoms come in different sizes, shapes, and styles, but most condoms will fit most men. - Another choice is the Reality condom, which is made of polyurethane and is designed to fit inside the woman`s vagina for vaginal sex, and the anus for anal sex. Use the directions from the manufacturer that come with Reality condoms. - Open and handle condoms carefully. Never use a condom that is in a damaged package or is past its expiration date. Condoms should be stored loosely in a cool, dry place (not in your wallet or the glove compartment of your car) and kept where you can easily get them if you decide to have sex. - To reduce friction that can cause breakage, use plenty of water-based lubricant on the outside of the male latex condom and a small amount on the inside at the tip. With the Reality condom use plenty of lubricant on both the inside and outside. Some condoms come with lubricant, but often there is not enough, so additional lubricant is recommended. Never use oil-based lubricants like Vaseline, hand cream, Crisco, or mineral oil with latex condoms. Oil-based lubricants can rapidly break down latex and allow the virus to pass through. Water-based lubricants include K-Y Jelly, Slippery stuff, ForPlay, Astroglide, ID Lubricants and most contraceptive jellies. These can be found in grocery or drug stores next to the condoms. WARNING: Some lubricants contain nonoxynol 9, which can cause irritation. This irritation may increase the risk of HIV transmission. We do NOT advise the use of nonoxynol 9 or products containing it for STD and HIV prevention!

The male condom should be put on after erection and before any sexual touch. Remember that pre-cum is also infected with HIV. The Reality condom should go in before sex - it can be inserted up to 8 hours before use. Never use the Reality and the male condoms together or two male condoms at the same time. - Some male condoms have a reservoir tip; some don`t. In either case, the tip of the condom should be squeezed while rolling it down onto the penis in order to leave an airless pocket to collect semen. If the penis is natural and has a foreskin, try pulling back the foreskin before unrolling the condom all the way down to the base of the penis. Some men don`t like to pull back the foreskin because they`ve found that the condom slides off when the foreskin is pulled back. If you have trouble with this, consider keeping the foreskin down before putting on the condom or try using a Reality condom with your partner. - After intercourse, withdraw the penis while still erect, holding the base of the condom to prevent it from slipping off or spilling semen. Remove the condom and wash the penis with soap and water. - Use a condom only once and dispose of it in the garbage; do not flush condoms down the toilet. Never reuse a condom. - Use a condom EVERY TIME during sex when transmission or acquisition of HIV is possible.

Casual Contact. HIV is a fragile virus outside the body. It quickly becomes inactive when exposed to air, soap and common disinfectants such as bleach.

There is no risk of getting HIV from: donating blood mosquito bites toilet seats shaking hands hugging sharing eating utensils or drinking containers food or objects handled by people with HIV or AIDS spending time in the same house, business or public place with people who have HIV or AIDS.

The best way to avoid HIV infection (and other blood-borne infections like hepatitis B and C) from injection drug use is to stop injecting drugs. Drug treatment can help. If treatment is not available or you cannot quit on your own, use a brand new sterile syringe and needle every time you inject or divide drugs. Do not share drug using "works" with anyone else. This includes needles, syringes, cookers, cottons, mixing and bleaching water, and all other supplies. If you do not have new clean equipment, thoroughly disinfect all drug use tools with bleach before re-use. It is also important to dispose of used works safely. Discarding needles in the trash, on the street, or flushing them down the toilet is dangerous.

Drug use (including use of alcohol) can impair judgment and decision-making. This can increase risk for HIV, especially if you have sex while high. High or not, you can successfully use condoms and clean injection works. Plan ahead, carry condoms and stick to your prevention plan. *A person does not need a prescription to purchase syringes in Nevada. However, a pharmacist may refuse to sell to people based on their own judgment.

The only way to completely avoid the sexual transmission of HIV is to abstain from anal, oral and vaginal sexual. If you choose to have sex, it is safest when you practice monogamy with an uninfected partner. Monogamy is when two people have sex only with each other. For those with a new sex partner, both can abstain from sex, or use condoms every time during anal, vaginal and oral sex for at least 3 months and then get tested for HIV and other STDs. At that time, if both partners are HIV negative AND both partners are completely avoiding other risk behaviors (e.g., sharing needles or having other sex partners), then unprotected sex with each other is not a risk for HIV transmission. For someone with an HIV positive partner or a partner who does not know his/her HIV status or multiple sexual partners, touching, dry kissing, body rubbing, and mutual masturbation are the safest sexual activities. However, simple, skin-to-skin touching can spread other STDs. For any penetrative sex acts such as vaginal, anal or oral sex, condoms are highly effective at reducing the risk of HIV transmission when used consistently and correctly - every time, from beginning to end of each sex act. For more information on condom use see the answer to the question, "Do condoms provide 100% protection from HIV?"

HIV can be transmitted when blood, semen (including pre-seminal fluid or pre-cum), vaginal fluids, or breast milk from an infected person enters the body of an uninfected person. HIV must get into the bloodstream or body in order to cause infection. Transmission most often occurs during unprotected sex or during injection drug use when equipment is shared. An infected woman who becomes pregnant can transmit HIV to her baby during pregnancy or during birth, but this risk is significantly less if the woman takes antiretroviral drugs. She can also pass HIV to her newborn if she breastfeeds. Anyone infected with HIV can transmit it, whether or not they appear sick, have an AIDS diagnosis, or are successfully treating their infection with antiretroviral drugs. HIV is spread in the following ways: Unprotected anal, vaginal or oral sex HIV can enter the body during sex through the anus, vagina, opening at the end of the penis or mouth and through cuts, sores and abrasions on the skin. Unprotected anal and vaginal sex have the highest risk of infection. There are a growing number of reported cases where HIV has been transmitted during oral sex (mouth to genital contact), but oral sex is much less risky than anal or vaginal sex.

Anyone having unprotected sex (inserting or receiving partner) with an infected person is at risk of getting HIV. The person most at risk is the receiving partner. Heterosexually, women are at higher risk than men.

Blood exposure. Sharing needles or drug injection equipment can transmit HIV (and other viruses like hepatitis). After use, small amounts of blood can remain in the used needles, syringes, cookers, cottons, and water. This remaining blood can enter the body of the next user when any of these items are shared. If this blood is HIV infected, transmission can easily occur.

There is a very small but real risk of health care workers getting HIV from infected patients as a result of needle stick accidents or when blood gets into a worker`s open cut or a mucous membrane in their eyes, mouth or nose. The risk for health care workers is greatly reduced when universal precautions are carefully followed, such as safe disposal of sharps, wearing latex gloves, etc. Universal precautions also protect patients.

Very rarely in this country is HIV transmitted when receiving a blood transfusion, blood clotting factors, an organ or tissue transplant (the risk of acquiring HIV from a blood transfusion is approximately 1 in a million). Before 1985, there were no tests to screen blood and organ donations for HIV. Now, blood, organ and tissue banks extensively test all specimens for HIV and other blood-borne germs.

Mother to child If a woman is infected with HIV, she can give it to her baby during pregnancy, during birth, or by breastfeeding. Early in the epidemic, 25% (1 out of 4) of babies born to HIV-infected women in this country became infected with HIV. Now, in developed countries where early detection of HIV is possible, treatment with the latest antiretroviral medications can reduce this rate to about 1% (1 out of 100). All pregnant women should see a doctor, be tested for HIV, and if infected, obtain the best treatment.

Not at this time. Medical providers have become much better at identifying, monitoring, and treating HIV infection and AIDS. In 1995, a new class of drugs known as protease inhibitors became available. These new medications, used in combination with other antiretroviral drugs, have dramatically improved the health and quality of life for many people living with HIV/AIDS. While there is not currently a cure or vaccine for HIV/AIDS, there are many things that people living with HIV/AIDS can do to remain healthy and to live longer. The first step for anyone who has HIV infection is to see a knowledgeable, experienced medical provider. This provider will be able to assess and monitor the infection, and, if appropriate, prescribe antiretroviral drugs. People at increased risk for HIV infection need to be tested for HIV antibodies every 3-6 months. This way they can seek medical care at the earliest possible opportunity if they become infected with HIV. Early detection can also reduce the chance of HIV transmission when people are most infectious. Although medical care and drugs are expensive, programs exist to ensure that people with HIV infection and AIDS can get the treatment and care they need.

Between 50-90% of people with new HIV infections have mild to severe "flu-like" symptoms 2 weeks to 3 months from the time of HIV exposure. Others do not have any symptoms. In general, symptoms are not a reliable way to tell if someone has been infected with HIV; the only way to know for sure is to get tested. Many of the symptoms of early HIV infection are the same as for other, less serious illnesses. People who may have been exposed to HIV should see a doctor promptly if the following symptoms occur within 3 months of the exposure:

A persistent fever of over 101 degrees that lasts more than 2 days without a known cause

Constant tiredness

Night sweats that soak your pajamas or sheets

A persistent rash of unknown cause

Persistent swollen glands (lumps under the skin) which occur in several places at once (especially the neck, armpits and groin)

AIDS (Acquired Immune Deficiency Syndrome) is a medical condition resulting from HIV infection, usually after many years. By the time a person is given an AIDS diagnosis by a doctor, HIV has seriously damaged the body`s immune system. There are effective treatments to prevent, as well as treat, these serious illnesses.

Human Immunodeficiency Virus (HIV) is the virus that causes AIDS. HIV kills specific white blood cells (T cells), which are an important part of our immune systems. Without treatment, HIV gradually destroys the body`s defenses against disease (it takes an average of 8-10 years), leaving it vulnerable to many infections and cancers. But treatment with antiretroviral drugs can slow or stop the harmful effects of retroviruses like HIV, so that many people with HIV are living longer, healthier lives.

There are several types of HIV antibody tests used today. All are highly accurate at detecting HIV antibodies (HIV antibodies are specific proteins made in response to an HIV infection). After infection with HIV, however, it can take up to 3 months for enough HIV antibodies to develop to be detected by the test.

A negative HIV antibody test result means that a person does not have detectable HIV antibodies at the time of the test. Since it can take up to 3 months after HIV infection for enough antibodies to develop, a negative test result is reliable only if the person has not had any sexual or needle-sharing risk behavior (or other exposure to infectious body fluids) during the 3 months prior to testing. Some people with recent risk behavior will test HIV antibody negative, yet may have actually been infected during the previous 3 months. These people will be highly contagious and may easily transmit HIV to their sex and needle-sharing partners. A high proportion of HIV transmission may occur when people are unaware of their infection. Finally, a negative test result does not mean that a person is safe from future HIV infection. People who test HIV antibody negative are urged to continue to follow HIV prevention guidelines to avoid becoming infected. People who continue risk behaviors are advised to re-test at least every 6 months.

A positive HIV antibody test result means that HIV antibodies are present because the virus is present - the person is infected with HIV (with the exception of newborn babies who are born with their mothers` antibodies). A positive test does not mean the person has AIDS, although many HIV-positive people may develop AIDS in the future. Anyone who tests HIV-positive can transmit the virus to others, regardless of how long they have been infected, whether they have AIDS or other symptoms, or whether their HIV infection is being treated with antiretroviral drugs. It is extremely important that HIV-positive people follow HIV prevention guidelines, not only to protect their partners from getting HIV infection, but also to protect themselves from other germs that could cause HIV/AIDS-related disease. People at increased risk of HIV infection should NEVER donate blood, plasma, or other organs, or go to such facilities to be tested.

It can take up to 3 months after HIV infection for enough antibodies to develop, therefore a negative test result is reliable only if the person has not had any sexual or needle-sharing risk behavior (or other exposure to infectious body fluids) during the 3 months prior to testing. Some people with recent risk behavior will test HIV antibody negative, yet may have actually been infected during the previous 3 months. Every exposure pushes the window period out another months.

Anyone can get HIV if they have unprotected sex or share injection drug equipment with someone who is infected. The virus does not discriminate - it can infect males or females, babies, teens, adults or senior citizens. You cannot look at someone and know they have HIV. In fact, as many as 1 out of 3 people who have HIV (33%) have no idea they are infected.

Air Quality

Wood stoves and fireplaces are regulated by the Washoe County Health District because they are major contributors to air pollution in the Truckee Meadows. Therefore before you make a purchase, it is important for you to spend some time researching whether it is legal to put a wood burning appliance in your home. To determine if you can install a wood burning stove or fireplace in your home, you need the following information, then call (775) 784-7200 (AQMD).

Normally, a business which emits 2 pounds or more per day of criteria air pollutants or 1 pound per day or more of toxic air pollutants will require a permit to operate. Different types of air pollution control devices are also required for different processes depending upon the size of the operation for compliance with the AQMD regulations. Applications may be obtained by downloading from the District Health Department Web site. For further information, please contact one of our environmental engineers at 784-7200 for help with the necessary information for application submittal.

Just call 784-7200 (24 hours per day) and your complaint will be logged onto an official AQMD complaint form. After that, within "normal" hours of operation, an air quality specialist will investigate your concerns and determine if there is a violation of the AQMD regulations. If a violation exists, the person or business will be required to correct the problem. A Notice of Violation may also be issued.

Every year between November 1 and February 28, the Washoe County Health District Air Quality Management Division uses the Green, Yellow, Red Burn Code Program to inform area residents whether or not lighting stoves or fireplaces is allowed, or is advisable.

Washoe County residents can get a daily air quality update by visiting www.OurCleanAir.com or by calling the Air Quality Hotline at (775) 785-4110. They can also get this update by listening to television and radio weather forecasts, or by checking the Reno-Gazette Journal's weather page.

The local asbestos regulations essentially mirrors the federal requirements. If you own a commercial building and want to do some remodeling, an asbestos survey will need to be completed by a certified consultant to determine the presence or absence of any asbestos materials. If present, a certified abatement contractor will need to remove the asbestos before the project can proceed. In addition, the property owner will need to obtain an asbestos acknowledgment form from the AQMD prior to obtaining a building permit from the local building departments. For further information, please call 784-7200.

Antimicrobial Resistance

For household use, antibacterial products are no better than ordinary soap for preventing infections. Hand washing for 15 seconds with ordinary soap and water will reduce the risk of most common infections and does not add to antibiotic resistance.

Yes. It is becoming a major public health concern. Each time you take an antibiotic unnecessarily or improperly, you increase your chance of developing drug-resistant bacteria. We could run out of ways to kill disease-causing bacteria.

You don't know who is carrying anti-biotic resistant bacteria and they may pass that resistant bacteria on to you and make you ill. This could mean stronger, more expensive antibiotics, hospitalization and, sometimes, death.

Unnecessary antibiotics can be harmful. Antibiotics only fight bacterial infections. They do nothing to help viral illnesses like colds or influenza (flu). If you take an antibiotic when it is not necessary, such as for a cold, you increase the risk of developing an infection caused by antibiotic-resistant bacteria. Antibiotics also destroy good bacteria in your body.

No. The common cold and the flu (influenza) are caused by viruses, not by bacteria. Antibiotics do not work against viruses. Normal cold symptoms include sore throat, fever, cough, and/or a runny nose. A runny nose often starts out with clear drainage and then turns to a green or yellow color. This is a good sign that the body is fighting the virus. If your runny nose is not getting better after 10-14 days, please talk to your healthcare provider.

Sometimes. Bacteria or viruses cause sinus infections. Antibiotics are needed for bacterial sinus infections. A bacterial sinus infection may be present if cold symptoms do not improve after 10-14 days.

Antibiotics either inhibit the growth of bacteria (bacteriostatic) or actually kill the bacteria (bacteriocidal). By stopping the growth of bacteria, it gives the body time to mount an immune response and allows the body to eliminate the bacteria. Drugs that kill the bacteria are the preferred choice when someone has a weakened immune system and whose body cannot destroy the bacteria on its own. Antibiotics are not effective against viruses.

Some bacteria are naturally resistant to certain types of antibiotics. Bacteria can also become resistant by a genetic mutation or by acquiring resistance from another bacterium. Because bacteria can collect multiple resistance traits over time, they can become resistant to many different families of antibiotics, which allows the resistant bacteria to continue to live/and multiply even in the presence of antibiotic treatment.

There are three ways in which you can get an antibiotic-resistant infection:

You can develop antibiotic-resistant infections when you take an antibiotic. The bacteria could figure out how to outsmart the antibiotic and stay alive. In that case, you can transmit these resistant bacteria to others and they too may become ill.

You can catch antibiotic resistant-infections from people or objects around you that are infected with resistant bacteria. Not properly washing hands can increase your risk of catching all kinds of infections.

You can develop an antibiotic-resistant infection when the bacteria inside your body change; it mutates or acquires genes that allow them to resist antibiotic treatment.

Antibiotic-resistant bacteria can also develop in pigs, chickens, cattle and other farm animals, which are exposed to low doses of antibiotics in their daily feed. These resistant bacteria can then spread to humans, causing antibiotic-resistant infections. Guidelines are being developed to address this concern.

Bacteria (singular: bacterium) are one-celled organisms visible only through a microscope. There are many types of bacteria, only some of which cause disease. Most are harmless and even some are helpful (good bacteria), by aiding digestion or breaking down rotting material. Bacteria are found almost everywhere.

Also, you should take antibiotics only when necessary. Don't insist on an antibiotic when your doctor says, "no". Never take an antibiotic for a viral infection such as cold, cough, or flu. Take an antibiotic exactly as the doctor prescribes. And take the antibiotic until it is gone, even if you are feeling better. Never save the medication to treat yourself or others later.

It is very important to have your body help itself. Get plenty of sleep, drink lots of fluids and eat healthy foods. Help decrease the symptoms by using a vaporizer or use over-the-counter medicines like saline nose drops, gargles or throat lozenges. Viral infections simply take time to get better.

An antibiotic is a powerful medication designed to kill bacteria or stop them from growing, such as an illness caused by strep throat. They cannot cure illnesses caused by viruses, such as a cold or the flu. Different antibiotics may be used for different types of bacterial infections. Your health care provider will determine what infection you have and if an antibiotic is appropriate to treat it.

Antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth. These bacteria are considered to be resistant to an antibiotic. Overuse and misuse of antibiotics are the main reason for antibiotic resistance.

Birth and Death Records

If you are a qualified applicant, you can complete an application form and mail it along with a copy of your valid photo identification and a check or money order, payable to Washoe County Health District, or you can appear in person at the office which is located in the Washoe County Health District, 1001 E. Ninth Street, Reno, Building B, first floor, Birth and Death Records. Our hours are listed on the Vital Statistics Program page.

Birth and death certificates are confidential in the State of Nevada and may only be released to a qualified applicant. A qualified applicant is defined as the registrant, or a direct family member by blood or marriage, his or her guardian (Must provide certified original court order appointing guardianship.), or his or her legal representative. For more information, refer to NRS 440.650 and NAC 440.070.

The Vital Statistics Office provides certified copies of Washoe County birth and death certificates either at the office or by mail. Fees for certified copies are set by statute and the current prices can be found on the Vital Statistics fee page.

The office is located in the Washoe County Health District, 1001 E. Ninth Street, Reno, Building B, first floor, Birth & Death Records. Our hours are listed on the Vital Statistics Program page. For more information call (775) 328-2456.

Waste that is to be sent for resource recovery or recycling must be separated at the site of generation. For example, if your business generates glass and aluminum cans and you want to recycle it, the glass and aluminum must separated from your other solid waste. Once separated, the recyclable materials (e.g., glass and aluminum cans) must be placed in a container for collection by a waste hauler permitted to collect and transport recyclable materials.

There is no easy answer to this question. Recyclable materials are subject to the same supply and demand limitations faced by most businesses. Flux in the market for recyclable materials has a major impact on their value. Some recyclable materials have enough value that a permitted waste hauler will collect them for free or even pay for the material. Other recyclable materials may have a low value, requiring the permitted waste hauler to charge you a nominal fee to collect them. As with most resources, collection and transportation costs may offset any profit that could be realized from recycling.

For more detailed information, please contact the Washoe County Health District, Environmental Health Services Division at (775) 328-2434. The staff assigned to the Waste Management Program can answer your questions and provide more information.

Any waste material that has an end use or can be re-processed into a usable material, product or item. This includes, but is not limited to, food waste, aluminum, glass, yard debris, plastic, office paper, etc. Additionally, this includes any solid waste that can be processed and used as a feedstock for energy generation. Not all recyclable materials can be recycled in Washoe County due to lack of markets, availability of necessary collection services, etc. Prior to recycling any material, it is important to identify the method of transportation and the final processing location.

There are environmental benefits to recycling that are well documented. For example, paper recycling has greatly reduced the need to harvest virgin timber to make paper products. Instead, waste paper is re-processed and used in the manufacturing of new paper. Thus, the act of recycling promotes efficient and cost effective use of solid waste without depleting limited natural resources. This effort also limits environmental degradation that often results when extracting or harvesting virgin raw materials.

Another benefit can be realized by promoting the fact that your business recycles. Sustainability, responsible use of resources and commitment to community can be featured as part of an advertising campaign. Further, many residents are demonstrating a preference for businesses that actively recycle. Finally, by reducing the overall amount of waste that must be disposed, your business may reduce the cost for disposal. For example, if a business currently uses a six (6) yard dumpster, but can divert 20 – 30% of their waste to recycling, a four (4) yard dumpster would be adequate, resulting in lowered cost for service to the dumpster.

You can give out samples if they are prepackaged. If the samples are not prepackaged a temporary sampling permit will be needed. Contact the Health District for details on obtaining a temporary sampling permit.

No, but you need to be registered with the Washoe County Health District to sell in Washoe County. To sell in other Nevada Counties you must be registered with the Health Authority which has jurisdiction in that area.

This is due to the inherent risks that may be associated with these non-allowable foods, since they will not be inspected or regulated by Local/State/Federal health officials. The bill passed by the Nevada Legislature allowed only certain listed foods to be provided.

In some people, particularly children under five years of age and the elderly, the infection can also cause a complication called hemolytic uremic syndrome, in which the red blood cells are destroyed and the kidneys fail. About two to seven percent of infections lead to this complication. In the United States, hemolytic uremic syndrome is the principal cause of acute kidney failure in children, and most cases of hemolytic uremic syndrome are caused by E. coli O157:H7.

E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless and live in the intestines of healthy humans and animals, this strain produces a powerful toxin and can cause severe illness.

A well construction permit must be obtained from the Washoe County Health District to construct, drill, recondition or plug a well. The permit applications are available and are processed at the Health District offices.

The Health Department is located at the corner of 9th Street and Wells Ave., just off the freeway and next to the fairgrounds. The address is 1001 East 9th Street, Building B. If you are traveling North on Wells, the entrance to the clinic is the first right (into the parking lot) after passing 9th Street. You can enter the door marked CLINIC SERVICES.

If you take an Emergency Contraception (the Plan B pill) within five days of unprotected sex you can reduce your chance of pregnancy by up to 75%. You need to be seen by a nurse to receive this medication. Call the clinic ASAP to make an appointment. For weekend, holiday or evening emergency contraception providers in the local area dial 1-888-NOT-2-LATE.

We see women in their reproductive years, which means during the time in their lives when they are able to have children. When a woman reaches menopause (stops having her period) we refer her to a different clinic for annual exams.

Immunizations

A parent or legal guardian must be the person who receives the vaccine information sheet (VIS), HIPAA informational sheet, HIPAA consent form and completes the vaccine administration record for the child receiving shots. Vaccine Information Sheets (VIS).

Many shot records indicate when the next vaccinations are due. Parents can check with their physician's office or clinic. Complete childhood and adult immunization schedules are available at http://www.cdc.gov/vaccines/recs/schedules/. Annual influenza (flu) vaccination is recommended for children aged 6 months or older.

Medical Reserve Corps

The primary responsibility of the Washoe County MRC is to respond to local incidents. In the event of a regional or national incident, if a request is made for assistance from our units, members may be deployed elsewhere only when they are not needed locally.

As part of the new member orientation, you will learn how to develop a disaster plan for your family. Family members should be included in planning and decision-making, preparing an emergency kit, and gathering appropriate resources to activate the plan in the event of an emergency.

Public Health professionals, including administrators, epidemiologists, health educators, and communicable disease and environmental health specialists are needed to help promote community health during non-emergency situations, as well as during disasters.

Membership is voluntary, and you are not required to assist in any particular response effort. Within a short period after an incident occurs, you may be contacted by MRC staff and asked to assist. Your ability to respond to a request will not affect your continued membership in the MRC.

Potential risks depend upon the type, magnitude and duration of the incident. The orientation session, trainings, and exercises prepare MRC members to protect themselves while working in the response efforts. A member always has the opportunity to decline deployment if he or she is uncomfortable with the assignment, without affecting continued membership in the MRC.

Each member is encouraged to have a signed memorandum of understanding with his or her employer to acknowledge that the employee has committed time to the MRC and the employer understands the employee may be unable to fulfill job responsibilities if deployed in response to an incident.

Members who will fill supervisory roles can expect to spend approximately 28 hours in training the first year. Members who will fill non-supervisory roles can expect to spend approximately 20 hours in training the first year (23 if they need CPR/First Aid training.) Training time in subsequent years will vary, depending upon the member`s role. Additionally, all members will be expected to participate in an eight-hour exercise each year.

Much of the training is in the form of online courses which can be completed on your home computer, at your own pace, at whatever time is convenient for you. All training is provided at no cost to the volunteer.

The concept of just-in-time training is to provide training at the time it is most needed. In emergency management, just-in-time training incorporates information specific to the type and magnitude of the incident. The MRC uses just-in-time training for its members immediately after deployment to issue assignments and equipment necessary for their role in the incident.

In the event of an incident, time and resources are simply not available to process, train and manage spontaneous volunteers. The MRC registers and screens members, verifying medical licenses in advance to ensure a rapid, coordinated response. Spontaneous volunteers often present a hindrance to incident management and may be turned away. If you want to be part of disaster response effort, become a member of the MRC now so you can be deployed quickly when an emergency occurs.

Through the feces of people or animals including birds and especially reptiles (this includes turtles) to other people or animals, usually through food that has been contaminated, either though direct contact with infected feces or through unwashed hands of an infected food handler (did not wash hands after using the bathroom).

Some develop severe diarrhea, leading to dehydration and hospitalization for rehydration with intravenous fluids.

In some cases, the infection can spread from the intestines to the bloodstream, then to other body sites. In these cases, death can result unless the infected person is treated promptly with antibiotics.

A small number of people go on to develop Reiter’s syndrome (pains in joints, irritation of the eyes and painful urination), which can last for months or years and can lead to chronic arthritis.

Young children, the elderly and the immunocompromised are the most likely to have severe infections.

Smoking Ban

Staff from the Environmental Health Services Division of the Health District have been conducting smoking ban compliance surveys during routine inspections since December 19, 2006. To date, an average 96.5% of permitted facilities were in compliance with the requirements set forth in the NCIAA during routine Environmental Health Services permit inspections.

Asking strangers, and sometimes even friends and family, to smoke outside can sometimes be stressful. It is important to remember that the vast majority of people are respectful and will abide by the law, if they are aware and reminded of it. Below are 4 ways to ask people who smoke to "take it outside". It may not be easy at first but you have the right and the responsibility to avoid secondhand smoke.

As the business owner/manager to enforce the law: I thought this was a non-smoking business. Would you please ask them to smoke outside?

Remind them of the law: Maybe you didn't know, but Nevada law prohibits smoking in this area/building/business. Smoking is allowed outside.

Be polite: I would like to ask a favor. Would you mind smoking outside? This is a non-smoking area.

It is the smoke, not the smoker that is the problem: Would you not smoke right now? I`d really appreciate it.

Smokers play an important role in helping to implement the law. First and foremost, it is now illegal for you to smoke indoors in a facility where smoking has been banned. Even if a "No Smoking" sign is not displayed there, you are still required by law to refrain from smoking. You should also not bring any ashtrays or items used as ashtrays into a facility where smoking is now banned. You may still smoke anywhere outside of a facility where smoking is now banned indoors. You may also still smoke indoors at the following types of businesses:

Areas within casinos where loitering by minors is already prohibited by state law;

Stand-alone bars, taverns, and saloons that do not require a permit to serve food;

Strip clubs and brothels;

Retail tobacco stores;

Private residences, including those which may serve as an office workplace, except if used as a childcare, an adult day care, or a health care facility; and

Hotel and motel rooms, but only if allowed by the facility operator, so please ask the operator first before smoking there.

If you are uncertain about being able to smoke indoors, please ask the owner and/or manager of the facility first before smoking there. Your compliance with the new law helps protect non-smokers and children from the dangers of secondhand smoke. Your compliance also helps merchants meet their responsibilities under the new law. If you are asked by a representative of the business to refrain from smoking inside their facility, please do as they ask. It is the business's responsibility to enforce the new law in their establishment; if you are found smoking indoors at a location where smoking is now banned, then the business itself could be cited and required to pay a fine. You, too, could be found guilty of a misdemeanor, which generally carries a fine imposed by a judge. A person who violates this ban is also liable for a civil penalty of $100 for each violation.

Banning smoking in indoor spaces has been shown to have a positive impact for business owners in addition to the general community. Studies have shown that banning smoking in restaurants and bars can boost revenues and increase employment. For example, taxable sales receipts for bars and restaurants have increased every year in California since their smoking ban took effect in 2002. In New York City, tax receipts for restaurant and bars increased 8.7 percent, and employment increased by 10,600 jobs since their 2003 smoking ban went into effect; and, in Florida, retail sales for restaurants, lunchrooms, and catering services increased by 7.3 percent after a 2003 smoking ban. Florida's sales and employment in the hotel, restaurant, and tourism industries also were not hurt. Smoking bans in places of employment also have been shown to lower employee sick leave usage, health insurance costs, fire insurance rates, and cleaning costs.

Many studies have been conducted about the business impact of indoor smoking bans. For more information about these studies, please visit: tobacco.ucsf.edu.

Compliance with the ban is the responsibility of the owner, manager or operator of an area where smoking is prohibited. A reasonable effort to prevent smoking should be made by this individual or group of individuals. Health authorities, police officers of cities or towns, sheriffs and their deputies shall, within their respective jurisdictions, enforce the provisions of the ban and shall issue citations for violations of the ban.

Exposure to secondhand smoke has been linked to numerous life-threatening diseases such as heart attack, stroke, and cancer. Eliminating smoking in indoor spaces reduces exposure to secondhand smoke, thereby reducing the occurrence of these chronic illnesses. Research in communities that have implemented indoor smoking bans shows significant improvement to public health after the ban goes into effect. For example, hospital admissions for heart attacks dropped 40 percent in the six months following an indoor smoking ban in Helena, Montana; and, in Pueblo, Colorado, heart attacks declined 30 percent in 18 months after smoking was banned indoors.

The cost to comply with the law will vary for each business, but, in general, there are minimal costs. Employers must clearly and conspicuously post "No Smoking" signs in their facilities at every entrance. They also are required to remove all ashtrays and other smoking paraphernalia from any area where smoking is prohibited. For some businesses, additional costs may be associated with the removal of built-in ashtrays or other smoking-related items.

A person who is found to violate the ban is guilty of a misdemeanor, which generally carries a fine imposed by a judge. In addition, a person who violates this ban is liable for a civil penalty of $100 for each violation.

As a result of the voters' mandate, smoking tobacco in any form now is prohibited within indoor places of employment, including, but not limited to: childcare facilities, movie theatres, video arcades; government buildings and public places; malls and retail establishments; all areas of grocery stores; all indoor areas within restaurants; and within school buildings and on school property.

Smoking tobacco is not prohibited in areas within casinos where loitering by minors is already prohibited by state law; stand-alone bars, taverns, and saloons that do not require a permit to serve food; strip clubs and brothels; retail tobacco stores; private residences, including those which may serve as an office workplace, except if used as a childcare, an adult day care or a health care facility; and hotel and motel rooms, if allowed by the facility operator.

Ashtrays or any items being used as an ashtray (e.g., beer bottles, coffee mugs, discarded trash, etc.) are considered smoking-related paraphernalia and must be removed from any area where smoking is prohibited. Merchants may still sell tobacco products.

Sec. 2 (9) (d) of the new law defines "public places" as "any enclosed areas to which the public is invited or in which the public is permitted." If a business meets this definition, then smoking must be banned there indoors, regardless of how the facility is owned. The law also defines a "place of employment" in Sec. 2 (9) (i) as "any enclosed area under the control of a public or private employer which employees frequent during the course of employment including, but not limited to, work areas, restrooms, hallways, employee lounges, cafeterias, conference and meeting rooms, lobbies and reception areas." Again, if a business meets this definition, then smoking must be banned indoors as described, regardless of how the facility is owned. The law does make an exception in Sec. 2 (3) (e) for private residences that serve as workplaces, except if they are being used as a childcare, adult day care, or health care facility.

Sec. 2 (7) of the new law states that "Health authorities, police officers of cities or towns, sheriffs and their deputies shall, within their respective jurisdictions, enforce the provisions of this Act and shall issue citations for violations of this Act[.]" The Washoe County Health District is the health authority for Washoe County (per NRS 202.2485). Therefore, the Washoe County Health District is required by law to enforce the smoking ban.

The ban was passed in order to protect the public from secondhand smoke. Secondhand smoke, also called environmental tobacco smoke, is a combination of smoke from the burning end of a cigarette, cigar or pipe and the smoke exhaled by smokers.

The U.S. Environmental Protection Agency (EPA) reports that secondhand smoke contains more than 4,000 substances, many of which are known to cause cancer in humans. In 2006, the U.S. Surgeon General released a comprehensive report stating that there is no risk-free level of secondhand smoke exposure.

Special Events/Temporary Food

No. However, there is an annual sampling permit available for vendors who wish to sample only, which applies to sanctioned Farmer's Markets, Craft Fairs, etc. This permit is valid only for the calendar year in which it was purchased.

No. The application is subject to review and food service operations must comply with regulations. Incomplete applications may be rejected. Applications may also be rejected based on inability to contact the person in charge of food service, menu item restrictions, or operational concerns.

Only registered cottage food operators can prepare food at home for a special event. All cottage food requirements must be followed and additional temporary food permitting may apply. Other than the above exception, no food preparation is allowed at a private residence for items served to the general public.

A temporary food establishment which operates at the same special event, in the same location and serves the same menu for at least three times during a calendar year will be eligible for a cumulative maximum fee. The temporary food establishment will be charged the permit fee for the event multiplied by three. The operation of the temporary food establishment is limited to 14 days per calendar year.

Food prepared in a private home and given away free of charge for charitable purposes does not require a permit. The food cannot be given to a food establishment and cannot be associated with a special event.

The following is a list of temporary food establishment permit exemptions (per regulation):

Bottled water, canned soft drinks.

Coffee/Tea with powdered non-dairy creamer or ultra-pasteurized creamer packaged in individual servings. (This exemption does not include beverages such as lattés and espressos that are mixed with dairy product by the vendor during preparation).

Commercially prepared acidic beverages (orange juice, lemonade, etc.) that are served from the original, properly labeled container without the addition of consumer ice or other regulated food product.

Draft beer and other alcoholic beverages (wine) that are served without the addition of consumer ice or the addition of other regulated food product.

Hot chocolate prepared without the use of potentially hazardous dairy products.

Non-potentially hazardous prepackaged baked goods with proper labeling from an approved source and requiring no on-site preparation (opening of package and contact with food item).

Non-potentially hazardous and unopened prepackaged foods from an approved source with proper labeling such as honey, jerked meats, potato chips, popcorn and other similar foods.

Produce sold from a produce stand where no sampling or food preparation is done.

Commercially prepared, prepackaged, and unopened ice cream that is appropriately labeled as to ingredients and manufacturer. Smoothie products (Jamba Juice and Keva Juice) made and prepackaged at the fixed permitted facility and appropriately labeled with ingredients and manufacturer.

Shelled and unshelled nuts, including flavored nuts for sample or sale.

Food Supplements that are offered for sample or sale without the addition of regulated food items. These include, but are not limited to vitamins, minerals, protein powder mixes, energy drinks, and herbal mixtures.

Foods from an approved source prepared for a “cook-off” or judging contest limited to one (1) gallon maximum of food product per contestant per day.

Yes. A religious, charitable or other nonprofit organization may, without possessing a permit from the Washoe County Health District (WCHD), sell food to raise money, whether or not the food was prepared at a private home, if the sale occurs on the premises of the organization.

No. In accordance with the Washoe County Health District (WCHD) Barbeque Policy, a fixed facility with a valid WCHD permit does not require a temporary food permit to barbeque food outside provided that food preparation, and service is conducted inside the facility. If food preparation and service is conducted outside the facility, a temporary food establishment permit is required.

No. If a fixed facility (grocery store, restaurant, etc.) already has a permit through the Washoe County Health District (WCHD) Food Protection Program, and the food will be sampled inside the store, a temporary food permit is not required. If the establishment wishes to sample or sell food outside, a temporary food permit is required.

If a mobile food unit has a valid Mobile Food Permit issued from the Washoe County Health District (WCHD) Food Protection Program, a temporary food permit is not required if the unit is fully self-contained as permitted and other food preparation or storage equipment is not required; however the mobile food unit must have the permission of the event promoter to participate in the event. If the mobile food unit does not have a valid WCHD Mobile Food Permit, a temporary food establishment permit is required.

NOTE concerning multiple-day special events: A mobile food unit must return to the designated servicing area DAILY as a condition required under the valid mobile permit. A temporary food establishment permit is required if the mobile unit remains in the same location for the duration of a multi-day event.

Any food prep performed prior to the first day of a special event must receive prior approval from the WCHD. Advanced preparation details must be disclosed in the temporary food permit application. Cooking and cooling of food items in advance is usually not allowed.

The promoter must first contact the city or county business licensing department (Washoe County, City of Reno or City of Sparks) in which the event is going to be held to ensure the necessary permits/licenses are obtained in order to operate within the city/county limits. If the event’s daily attendance is equal to or exceeds 5,000 persons per day, or the total attendance over a fourteen (14) day period is equal to or exceeds 10,000 persons, the promoter must obtain an Application for a Special Event Permit from the Washoe County Health District.

Potentially hazardous food includes any animal food (a food of animal origin) that is raw or heat-treated; a food of plant origin that is heat-treated or consists of raw seed sprouts; cut melons; and garlic-in-oil mixtures that are not modified in a way that prevents bacterial growth. Some examples of potentially hazardous food include, meat, poultry, fish, shell fish and crustaceans, milk and dairy products, cooked rice, and cooked beans, baked potatoes, tofu and soy protein foods, eggs (except those treated to eliminate Salmonella), raw sprouts, and sliced melons.

A special event is a transitory gathering such as, but not limited to, an activity (including soccer, baseball and softball league games), a celebration, festival or fundraiser which is open to the public.

If you take an Emergency Contraception (the Plan B pill) within five days of unprotected sex you can reduce your chance of pregnancy by up to 75%. You need to be seen by a nurse to receive this medication. Call the clinic ASAP to make an appointment. For weekend, holiday or evening emergency contraception providers in the local area dial 1-888-NOT-2-LATE.

The Health Department is located at the corner of 9th Street and Wells Ave., just off the freeway and next to the fairgrounds. The address is 1001 East 9th Street, Building B. If you are traveling North on Wells, the entrance to the clinic is the first right (into the parking lot) after passing 9th Street. You can enter the door marked clinic services.

The Teen Health Mall offers family planning services to help you plan the size of your family. By using birth control methods a woman has more control over when she has children and how many children she has.

The Advanced Practitioner of Nursing will review your medical history and determine what services you need (birth control, STD testing etc.).

If you are interested in birth control you may get it on the day of your visit; however, in some instances you will need to return to receive your method of birth control.

You may or may not receive a pelvic exam (having a nurse look and feel inside your vagina) and Pap smear on your first visit. If you receive birth control you will need to have a pelvic exam within 3 months.

Tuberculosis (TB)

Bacillus Calmette-Guérin (BCG) is a vaccine for tuberculosis. It is often given to infants and young children in countries with high rates of tuberculosis. It protects children and babies from developing severe forms of tuberculosis, like meningitis or miliary TB. It is not used routinely in the United States. Your skin test may be positive because of BCG vaccination.

However, a positive skin test is most likely due to infection with TB bacteria if:

You recently spent time with a person who has active TB disease

You are from an area of the world where active TB is very common (Africa, Latin America, Asia, Eastern Europe and Russia)

Usually has a skin test or a blood test result indicating TB infection*

Usually has a normal chest x-ray

Has TB bacteria in their body that are alive but inactive

Has no symptoms

Does not feel sick

Cannot spread TB to others

Can take treatment for LTBI to reduce their risk of developing TB disease

A Person with Active TB Disease:

Usually has a skin test or a blood test result indicating TB infection*

Usually has an abnormal chest x-ray

Has TB bacteria in their body that are active (growing)

Usually feels sick and experiences symptoms

May spread TB to others

Needs treatment to cure the active TB disease

* - A positive tuberculin skin test (TST) or a positive blood test only shows that you have been infected with the TB bacteria. Neither test can tell if you have TB disease, only if the TB bacteria are in your body.

Treating latent TB infection is essential to controlling and eliminating TB in the United States, because it substantially reduces the risk that the infection will progress to TB disease.

A person with TB infection can take medication called Isoniazid or Rifampin. This will kill the TB bacteria and greatly reduce the risk of TB disease from developing. Your doctor will decide which medicine is best for you. It is important to have health monitoring every month while taking either of these medications to be sure that you are not developing any harmful side effects. Your health care provider may order blood tests during your treatment.

There is now a 12 dose regimen that makes treating latent TB infection easier.

Considered one of the biggest breakthroughs in treatment for latent TB infection (LTBI) since the 1960s, the 12-dose regimen reduces treatment from 270 daily doses over 9 months, to 12 once-weekly doses over 3 months. It is a combination regimen of isoniazid and rifapentine; two of the most effective medications available for TB treatment.

Following the results of a recent large randomized control trial, the Centers for Disease Control and Prevention (CDC) released recommendations on the use of the new treatment regimen for LTBI:

It is recommended for otherwise healthy people aged 12 and older who are at an increased risk of developing TB disease

Close patient monitoring and the utilization of Direct Observed Therapy (DOT) in which a health care worker observes a person taking the treatment and monitors side effects is required for each of the 12 doses

It is an additional treatment option for LTBI and is not meant to replace other available treatment regimens

It takes a long time to kill all the TB bacteria. A person with TB disease typically must take 4 different medicines for 2 months:

Isoniazid

Rifampin

Pyrazinamide

Ethambutol

Then take Isoniazid and Rifampin for another 4-7 months depending on how much damage the bacteria have caused.

This treatment has been successful in treating TB disease for many years. In recent years, some TB bacteria strains have become resistant, (the medicines no longer kill the TB bacteria) to one or more of these drugs.

Multi-drug resistant (MDR) TB is resistant to the two strongest TB medicines, Rifampin and Isoniazid. The most common cause of drug resistance occurs when TB medications are not taken long enough and/or in the right amounts. Drug resistant TB is much more difficult and expensive to successfully treat. Extremely drug resistant (XDR) TB is a less common form of multi-drug resistant TB. There is resistance to Isoniazid and Rifampin, as well as most of the alternative drugs used against MDR TB. The Center for Disease Control and Prevention urges all health care practitioners to use directly observed therapy (DOT) in the treatment of tuberculosis.

When a person with active TB disease coughs or sneezes tiny droplets that contain TB bacteria are released into the air. If another person breathes air containing these droplets, they may become infected with the TB bacteria. However, not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: Latent TB infection (LTBI) and Active TB disease - both of which are treatable and curable.

You will need to have a chest x-ray. If your chest x-ray is normal, this means you have been infected with the TB bacteria but your immune system has "walled off" the bacteria and is protecting you from getting sick. Your doctor may recommend that you take medication to kill the bacteria so you will lower your risk of ever developing active TB disease. If your chest x-ray is abnormal and/or you have symptoms of TB disease your doctor will order additional tests to see if you have active disease.

To increase the success of TB disease treatment and decrease the risk of drug resistance, a health care worker observes each dose of TB medication taken.

Most persons believe they are able to take their medication without help. But 6 - 9 months is a long time to take antibiotics, especially after you start to feel better. Health care workers who provide DOT offer encouragement to complete treatment. People are human and humans are sometimes forgetful. DOT health care providers help people remember to take their medicine. They also check for harmful side effects and make sure the medicines are working as expected.

Tuberculosis (TB) is caused by a bacteria called Mycobacterium Tuberculosis (M. tuberculosis). TB usually attack the lungs. Sometimes TB bacteria attack other parts of the body such as, the kidney, spine or brain. TB disease is a serious illness, but with proper treatment it can be cured.

Vasectomy

A vasectomy is a permanent operation. Some doctors try to undo a vasectomy with surgery, but it is expensive and many times does not work. Make sure that you do not want to father any more children before you have a vasectomy.

A vasectomy is done in a doctor’s office or clinic. The doctor numbs the area and then makes a small cut in the scrotum (skin around the testicles) to get to the tubes that carry the sperm (sperm ducts). The doctor then closes off the sperm ducts so that sperm cannot get into the semen (what comes out during an orgasm). When there are no sperm in the semen, you cannot cause a pregnancy.

Yes, there are several temporary ways to prevent pregnancy. A man can use a condom or a woman can use methods like birth control pills, the Depo shot, the patch, an IUD as well as others. If you would like more information about these and other temporary ways to prevent pregnancy, talk to your health care provider.

With a vasectomy you don't have to worry about making a woman pregnant and you don't have to use a temporary method of family planning again (like birth control pills for women, condoms to prevent pregnancy, etc). However, the procedure will not protect you against STDs. A condom is still the best method for STD prevention.

The residential recycling program in Reno, Sparks, and Washoe County is voluntary. You must contact Waste Management Inc., at 329-8822 to request recycling bins. They will be delivered to your home. Also, dont forget to request a pickup schedule for recycled items. Your pickup day may be different that the regular garbage pickup.</p.

The best way to prevent this disposal dilemma is to not purchase products that contain hazardous materials or chemicals. However, if you cannot share the product or donate it for use by others, please solidify the waste with kitty litter, dirt, or coffee grinds and throw it away.

If you are a homeowner, you should first try to donate the unit or turn it in to one of the used computer retailers in the area. The last and least attractive alternative is to dispose of it in the trash. If you are a business, your computers cannot be landfilled!

In Washoe County, there are several ways to dispose of household paint. First, remove the lids from the paint cans and let the contents dry to a solid form. If there is more than 1/2 inch of paint, add kitty litter to absorb it. When the material is solidified, you can dispose of it your household trash. Or, secondly, you may pour the paint directly on to plastic tarps being careful not to spill on to the ground; let it harden, and then roll up the tarps and place in your household trash.

Contact the Nevada Small Business Development Center's "Business Environmental Program" at 1-800-882-3233, or 689-6699, or contact EPA for the free "Business Guide for Reducing Solid Waste" at www.epa.gov.

Most oil recycling centers will accept up to five gallons of used oil free-of-charge. Many of the large auto parts retailers in Washoe County will take motor oil from local residents. Make sure when transporting the oil, that it is in a secured container and is free of contamination by lubricants, gasoline, or antifreeze.

In other Northern Nevada Counties, call the State of Nevada Recycling Hotline at 1-800-597-5865.

Water Projects/Engineering

Washoe County Health District (WCHD) cannot accept any red line corrections on plans. All plans are submitted through the City of Reno, City of Sparks, and Washoe County Community Services Department (CSD) and therefore, all plans must match. Since WCHD is only a small piece of the total plan review, all revisions must be submitted through the correct agency and routed for review.

Monday mornings are available for meeting to discuss plan review comments and go over questions regarding water project reviews.

Meetings are held at the Washoe County Health District (WCHD) office, and scheduling is completed through WCHD staff at 775-328-2434 or the ehsplanreview@washoecounty.us email. All meetings are preferred to be scheduled between 8–9am.

When a special exception is requested, this must be completed by the Water System submitting the plan for whatever the proposed exception is to the plan. This must include why the minimum requirements of NAC 445A cannot be maintained, provide an analysis of any potential public health impacts, how this exception can be protective of public health, and any other pertinent information necessary to complete the review process.

Special exceptions are considered only on a case-by-case basis.

All special exceptions must be completed and submitted in writing to Washoe County Health District (WCHD). WCHD will coordinate with NDEP for concurrent review and comment as part of the review process.

A justification for each occurrence must be included with the plan submittal from the licensed professional preparing the plans. The justification must address the proposed design, why it is required, why the design could not be modified to meet the requirements of NAC 445A, and address the potential public health impacts associated with not meeting the minimum construction requirements.

Water project completion letters are required to be submitted to Washoe County Health District (WCHD) once all infrastructure has been installed and tested. These letters are also a requirement for the developer to receive the Certificate of Occupancy and be able to sell or occupy any structures proposed. Water Project Completion Letter

All separations are determined from the outside pipe or enclosure. All plan submittals should be utilizing the outside diameter of pipe, catch basin, sewer main, storm drain, etc to identify the minimum separation distance allowed per NAC 445A.

All water projects are submitted by the permitted public water system directly to the Washoe County Health District (WCHD) for review and approval. All WCHD correspondence will be distributed through the water system. For WCHD to approve a construction permit or final map, WCHD must review and approve the associated water project, and the two designs must match.